The primary goal of the proposed research is to advance our understanding of non-pharmacologic control of pain from burn injuries and other etiologies by applying state-of-the-art advances in immersive virtual reality (VR) technology. The significance of an effective psychological treatment for controlling severe burn pain includes reducing: (1) pain and suffering, (2) the length of hospital stay and associated costs, (3) the sid effects and diversion potential of opioid analgesics, and (4) the risk of developing chronic pain. The innovation involved in this project involves applying a relatively new technology, immersive VR to intensive treatment environments that previously presented too many challenges for this analgesic approach. Specifically, VR will be used in wet-wound wound treatments settings with children and adults that have extensive dressing changes and very large burn injuries. The participants from this study will involve children and adults, many of whom represent underserved minorities. The approach of this application will be to conduct a randomized controlled trial that compares high-immersion VR, with low-immersion VR and standard control conditions. 160 participants from two major regional burn centers will undergo all of their wound care sessions using either VR software specifically designed for burn care, nature pictures and sounds or standard treatment as usual. Participant pain relief will be measured by pain ratings on a number of dimensions and we have hypothesized that participants in the high-immersion VR group will report less pain than the two comparison groups. We will also investigate the impact of VR on a number of other relevant variables such as pain medication use and length of hospitalization. Participants will be followed at 6 and 12-month follow-up periods to investigate the impact of VR on long term pain ratings. We anticipate that the findings will have implications for controlling high levels of acute pain with safe, non-additive treatment approaches that facilitate the overall care and outcome of people who have survived severe burn injuries.